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Reuben Ilia

Publications and source records attributed to Reuben Ilia.

24 records · Page 2Linked to original sources
PubMed2003

Door to balloon and door to needle: temporal trends in delays to reperfusion.

BACKGROUND: Reperfusion practices have changed markedly over the last few years with the introduction of primary percutaneous coronary intervention. This technique has gained growing popularity in Israel, but little published data are available regarding the delays to primary PCI in real life in this country. OBJECTIVES: To examine temporal trends in time to reperfusion achieved in a large tertiary center over 6 years. RESULTS: Between 1997 and 2002, 1,031 patients were admitted to our hospital with ST elevation myocardial infarction. Of these, 62% underwent thrombolysis and 38% primary PCI. The proportion of patients referred for primary PCI increased steadily, from 14% in 1997 to 68% in 2002. Door to treatment time among patients referred for thrombolysis or primary PCI was 54 +/- 42 and 117 +/- 77 minutes, respectively (P < 0.00001). The door to needle time in patients given thrombolysis remained virtually unchanged during the study period at around 54 minutes. In contrast, the door to balloon time progressively and substantially decreased, from 175 +/- 164 minutes in 1997 to 96 +/- 52 minutes in 2002. CONCLUSIONS: There is a steady increase in the proportion of patients referred for primary PCI than for thrombolysis. The door to needle delay in patients given thrombolysis substantially exceeds the recommended time. The door to balloon time has declined considerably but still slightly exceeds the recommended time. Given the inherent delay between initiation of lysis and arterial recanalization, it appears from our experience that PCI does not substantially delay arterial reperfusion as compared to thrombolysis. Efforts should continue to minimize delays to reperfusion therapy.

Analysis of Variance↗
PubMed2002

Implantable cardioverter defibrillators in Israel: utilization and implantation trends.

BACKGROUND: Since its introduction, the implantable cardioverter defibrillator (ICD) has evolved to its present status as the dominant therapeutic modality for patients with life-threatening arrhythmias. Several randomized studies have shown the benefit of ICD implantation as the first choice of treatment for primary as well as secondary indications for ventricular arrhythmias. Therefore, it is expected that the use of ICDs will increase further. The main objectives of this study were to analyze the Israeli experience with ICD implantation from 1993 to 1999, to examine the diffusion of ICD therapy in Israel and the evolution of implantation patterns and indications. METHODS: We conducted a retrospective review and analysis of an ICD registry for the period of January 1993-December 1999. Data collected included demographic, administrative, clinical and survival data. RESULTS: A total of 732 new implantations were identified and reviewed. The mean length of follow up of all patients was 30.7+/-21.1 months. 86% of patients were males and the mean age at implantation was 62.6+/-12.4 years. 79% of patients had CAD and the mean EF of all patients was 29.2+/-11.2%. 135 patients (18.4%) died during follow-up. One, two and three-year survival rates were calculated and were 92.7%, 87.8% and 82.0% respectively. A steady increase in implantation rate and in implanting centers was observed over the years. CONCLUSIONS: ICD therapy is relatively expensive; therefore a national registry which is continuously monitored may be the most expedient method to follow clinical and economic aspects of the utilization of this therapeutic modality.

Aged↗
PubMed2002

Interactions of psychological factors and family history in relation to coronary artery disease.

BACKGROUND: Psychological factors including hostility, depression and stress have been associated with severity of coronary artery disease (CAD). However, few studies have examined interactions between such factors and typical CAD risk factors. Investigating interactive effects simulates their co-occurrence and complex effects in illness, as well as helping to identify groups of patients at greatest risk of morbidity. This study examined the interactive effects of hostility, hopelessness and daily hassles with family history of CAD in relation to CAD severity. DESIGN: Correlation design. METHODS: Seventy-three patients were assessed for hostility, hopelessness and daily hassles before undergoing coronary artery angiography. Severity of CAD was assessed by a cardiologist who was blind to patients' psychological data, with a scale considering type and proximity of occluded artery: the Ilia-score. RESULTS: Hostility significantly interacted with family history in relation to CAD severity. Hostility was positively correlated with CAD severity when family history was positive (r = 0.43, P< 0.05), but not when family history was absent (r = -0.10, NS). No other interaction effects were found. Interestingly, patients with family history of CAD had significantly lower hostility scores (14.4) compared to patients without such history (19.2; P= 0.002). No background or typical-risk factor correlated with CAD severity. CONCLUSION: Hostility synergistically interacted with family history of CAD in relation to CAD severity. The mechanisms of this interaction need to be explored in future studies. Hostility-reduction interventions provided to high-hostile patients with a genetic predisposition to CAD may be relevant for primary and secondary CAD prevention.

Coronary Artery Disease↗
PubMed2002

Rapid evolution from coronary dissection to pseudoaneurysm after stent implantation: a glimpse at the pathogenesis using intravascular ultrasound.

Coronary dissection during angioplasty can evolve into pseudoaneurysm. Stenting should prevent this complication. We present a case of coronary pseudoaneurysm after dissection that developed despite stent implantation. Intravascular ultrasound demonstrated no sealing of the false lumen due to undersizing and non-apposition to the wall by the stent.

Aortic Dissection↗
PubMedDate not supplied

Thrombocytopenia, immunoglobulin treatment, and acute myocardial infarction--a case report.

Platelets play a pivotal role in the pathophysiology of the acute coronary syndromes, and platelet inhibition is a cornerstone in the management of these patients. Patients with profound thrombocytopenia who present with an acute coronary syndrome present a difficult challenge. The authors report a patient with immune thrombocytopenic purpura who presented with acute myocardial infarction despite a very low platelet count and who sustained recurrent infarction after receiving immune globulin treatment. The best management of thrombocytopenic patients with acute coronary syndromes is uncertain, but extreme caution is needed before efforts are made to raise the platelet count in order to allow conventional treatment.

Coronary Angiography↗